Doctor Name: | MRS. KANDIS Z'LUNTE RANDLE |
NPI Number: | 1275987166 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 303 N Madison St Corinth, MS - 388345072 |
Business Phone Number: | 6622869883 |
Business Fax Number: | 6622849836 |
Mailing Address: | 25 Stonewood Cv, ECRU |
State: | MS |
Postal Code: | 388419245 |
Phone Number: | 2282349190 |
Fax Number: | |
NPI Enumeration Date: | 04/18/2016 |
NPI Last Update Date: | 04/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |